Induction

Artificial induction should only ever be carried out for medical or obstetric reasons, if the health of the mother or her baby would be adversely affected if the pregnancy continued.

Most inductions occur because pregnancy has continued to 42 weeks. After this length of time, the rate at which the placenta begins to deteriorate speeds up. Close monitoring will indicate whether or not the birth should be induced. In mothers over 35, placental insufficiency is more common after 40 weeks, so it might well be recommended that the birth is induced.

Other reasons for induction include:

• high blood pressure - where there is concern that this might escalate;
• unstable lie - labour might be induced after turning the baby to a head-down (cephalic) position;
• spontaneous rupture of membranes - if the waters have broken after 36 weeks of pregnancy, but labour hasn't commenced after a further 24 hours;
• genital herpes - some mothers are induced at 38 weeks if the disease is in remission, in order to avoid a caesarean section if spontaneous labour causes a flare-up of active disease;
• previous large baby - if a previous baby's birthweight was over 4Kg (8lb), as subsequent pregnancies tend to produce bigger babies. Birth may be induced at 38 weeks, to try and prevent a difficult labour and delivery.

Pregnancies are managed differently by different people, and some obstetric consultants have more rigid 'rules' than others. It is always worth discussing fully the basis on which suggestions are proposed, and decisions made. In any event, you need to be fully aware of any treatment and how it will affect you.

Artificial induction occurs in one of three ways:

• use of prostaglandin - pessaries which may ripen the cervix enough to start labour off. Prostaglandin can also be used within the cervical canal, actually inserted around the outside of the amniotic membranes, or orally.
• artificial rupture of the membranes - sudden loss of the amniotic fluid may bring the baby's head into closer contact with the cervix which can, in itself, help stimulate labour.
• an intravenous infusion of the synthetic hormone Syntocinon - used to stimulate contractions.

There are a number of things you can do to help initiate labour; one of them is for you and your husband or partner to make love. The stimulation of your nipples may encourage the secretion of the hormone oxytocin, which stimulates contractions (although only one nipple should be stimulated at a time). Prostaglandins in semen help to 'ripen' the cervix, and the internal contractions of an orgasm may start the contractions of labour off. It is certainly worth a try! Others have been known to swear by a hot curry...

One homoeopathic remedy that is recommended is Caulophyllum 30, every two hours for up to six doses in 24 hours. More specific prescribing needs a homoeopathic consultation. If you have been drinking raspberry leaf tea since 28 weeks, increase the amount from either one cup or tablet a day, to four cups or tablets a day. Acupuncture can be effective, as can reflexology although both require the help of a skilled practitioner. An aromatherapy massage to the lower back, using a blend of Lavender and Mandarin essential oils may enhance and co- ordinate contractions. Exercise, for example a brisk walk, could also help get labour started.

Even if you have a particular medical reason to be artificially induced, there may be a number of complementary therapies you can utilize in conjunction with this. And, because the contractions of an artificially induced labour can be quite strong and demanding, any additional, complementary pain relief should be considered as part of your pain relief options.